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General NPI Number Information
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NPI Number | 1295258846
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Entity Type | Individual
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Provider Name | JENNIFER MOGA LMHC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 66 W FLAGLER ST STE 900
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City | MIAMI
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State | FL
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Zip | 33130-1807
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Country | US
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Telephone | 786-244-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 16425 CARRARA WAY UNIT 201
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City | NAPLES
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State | FL
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Zip | 34110-3296
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Country | US
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Telephone | 239-385-2629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2102486
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH21273
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License Number State | FL
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